This study will analyze the effect of a thorough program in oral care in reducing oral infections in myelosuppressed cancer patients( acute nonlymphocytic leukemia or small cell lung carcinoma). There are virtually no reports of comprehensive studies of the effect of such care; in fact, many oncologists do not support the use of such oral care in their patients during periods of profound myelosuppression. This study will also analyze the potentially pathogenic microflora associated with acute exacerbations of pre-existent periodontal desease in patients with acute nonlymphocytic leukemia (ANLL). While there are several reports of changes in the alimentary tract microflora of such patients during myelosuppressive induction therapy, few if any reports exist describing causative organisms resident within the periodontium during this therapy. Analysis of the prevalence and types of such organisms could be very beneficial, since our previous studies have demonstrated that considerable patient morbidity is associated with acute periodontal infection. The specific aims of this project are as follows: 1) to examine thorough mechanical debridement of bacteria from the periodontal sites of the oral cavity as a means of reducing the prevalence of acute periodontal infection which result in systemic sequelae in myelosuppressed cancer patients; 2) to study the role of the oral microflora in the pathogenesis of acute periodontal infection in these patients; 3) to determine if the degree of pre-existent periodontal disease is related to changes in the periodontal flora during chemotherapy-induced myelosuppression. By studying these specific questions, further understanding of acute periodontal infection and associated microbial flora in myelosuppressed cancer patients should develop. These findings could lead to enhanced supportive care of these patients, by means of specific treatment modalities or, ideally, prevention of the acute infections.